In Pandemic, Parents Who Get Reminders More Likely to Vaccinate Kids

A new University of Michigan study found that the state immunization registry – the public health database that tracks vaccinations– can be an effective tool to encourage influenza vaccinations during a pandemic.

U-M researchers collaborated with the Michigan Department of Community Health (MDCH) to evaluate a statewide influenza vaccination reminder campaign conducted using the Michigan Care Improvement Registry (MCIR) during the H1N1 pandemic during 2009-10. The study results were published Nov. 14 in the American Journal of Public Health.

Reminder letters were mailed to parents of children with chronic health conditions such as asthma or diabetes, who had not yet received the vaccine that was recommended during the 2009-2010 H1N1 pandemic. The letter explained that children with chronic conditions were at increased risk for complications from H1N1 influenza and that parents should contact the child’s health care provider or local health department to make an appointment for vaccination.

Vaccination rates were higher for children whose parents were sent a reminder letter compared to children without chronic conditions who were not sent reminders.

Early in the 2009-2010 pandemic, reports from the CDC indicated that pediatric influenza deaths were more common among children with one or more chronic condition, heightening the importance of influenza vaccination among this priority group.

“Immunization registries like MCIR are important public health tools. This study shows the value of using immunization registries to prompt parents of children with a chronic condition to get that child vaccinated,” says Kevin Dombkowski, research associate professor with the University of Michigan’s Child Health Evaluation and Research (CHEAR) Unit. "This is an important illustration of public health preparedness,” says Dombkowski, who was the lead author of the study.

Dombkowski says that the Michigan Department of Community Health has invested significant amounts of time and resources to establish and maintain MCIR, which is one of the best immunization registries in the country.

“MDCH officials recognized the importance of being able to identify these high-risk kids in the event of a severe influenza season, so as a consequence, MCIR was ready when the H1N1 pandemic hit in 2009," he says. “All kids 6 months and older should receive flu vaccine each season, but those with chronic conditions are considered priority cases during pandemics or times of vaccine shortages.”

In 2005, MDCH began using administrative claims from the state’s Medicaid program to identify children with chronic health conditions. This unique approach makes Michigan a national leader in this type of proactive approach to protecting children at high risk for influenza-related complications, Dombkowski says. “It’s a model that most other states could follow.”

Additional authors: Anne E. Cowan, Shiming Dong, and Sarah J. Clark, all of the University of Michigan. Rachel C. Potter of the Michigan Department of Community Health, Lansing. Maureen Kolasa of the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention.

This work was funded by the Centers for Disease Control and Prevention (CDC) through a cooperative agreement with the Association of Prevention Teaching and Research.